Sparadise Llc | |
14602 Ne Fourth Plain Blvd Ste A Vancouver WA 98682-5080 | |
(608) 928-1913 | |
Not Available |
Full Name | Sparadise Llc |
---|---|
Speciality | Clinic/center - Multi-specialty |
Location | 14602 Ne Fourth Plain Blvd Ste A, Vancouver, Washington |
Authorized Official Name and Position | Kristen Clearwater (OWNER) |
Authorized Official Contact | 3606061694 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Sparadise Llc 14602 Ne Fourth Plain Blvd Ste A Vancouver WA 98682-5080 Ph: (360) 606-1694 | Sparadise Llc 14602 Ne Fourth Plain Blvd Ste A Vancouver WA 98682-5080 Ph: (608) 928-1913 |
NPI Number | 1568174241 |
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Provider Enumeration Date | 12/14/2022 |
Last Update Date | 12/14/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1568174241 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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